Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank

BMC Psychiatry

Daniel J Smith³  Jill P Pell³  Ian J Deary²  Beverly Roberts²  John Gallagher³  Andrew M McIntosh¹  Jonathan Evans³  Frances S Mair³  Zia Ul-Haq³  Daniel J Martin³  Breda Cullen³  Daniel Mackay³  Barbara I Nicholl³ 

[1] Division of Psychiatry, University of Edinburgh, Edinburgh, UK;Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK;Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, UK

关键词: Comorbidity;    Chronic pain;    Bipolar disorder;    Major depression;   

Others  :  1091443
DOI  :  10.1186/s12888-014-0350-4

 received in 2014-07-11, accepted in 2014-11-24,  发布年份 2014

【 摘 要 】

Background

Chronic pain has a strong association with major depressive disorder (MDD), but there is a relative paucity of studies on the association between chronic multisite pain and bipolar disorder (BD). Such studies are required to help elucidate the complex biological and psychological overlap between pain and mood disorders. The aim of this study is to investigate the relationship between chronic multisite pain and mood disorder across the unipolar-bipolar spectrum.

Methods

We conducted a cross-sectional study of 149,611 UK Biobank participants. Self-reported depressive and bipolar features were used to categorise participants into MDD and BD groups and a non-mood disordered comparison group. Multinomial logistic regression was used to establish whether there was an association between extent of chronic pain (independent variable) and mood disorder category (dependent variable), using no pain as the referent category, and adjusting for a wide range of potential sociodemographic, lifestyle and comorbidity confounders.

Results

Multisite pain was significantly more prevalent in participants with BD and MDD, for example, 4–7 pain sites: BD 5.8%, MDD 4.5%, and comparison group 1.8% (p < 0.001). A relationship was observed between extent of chronic pain and risk of BD and persisted after adjusting for confounders (relative to individuals with no chronic pain): 2–3 sites RRR of BD 1.84 (95% CI 1.61, 2.11); 4–7 sites RRR of BD 2.39 (95% CI 1.88, 3.03) and widespread pain RRR of BD 2.37 (95% CI 1.73, 3.23). A similar relationship was observed between chronic pain and MDD: 2–3 sites RRR of MDD 1.59 (95% CI 1.54, 1.65); 4–7 sites RRR of MDD 2.13 (95% CI 1.98, 2.30); widespread pain RRR of MDD 1.86 (95% CI 1.66, 2.08).

Conclusions

Individuals who report chronic pain and multiple sites of pain are more likely to have MDD and are at higher risk of BD. These findings highlight an important aspect of comorbidity in MDD and BD and may have implications for understanding the shared neurobiology of chronic pain and mood disorders.

【 授权许可】

   
2014 Nicholl et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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